University Hospital Hamburg-Eppendorf, University Heart Center Hamburg, Hamburg, Germany,
Clin Res Cardiol. 2014 Jun;103(6):477-85. doi: 10.1007/s00392-014-0674-6. Epub 2014 Feb 2.
In the Gutenberg Health Study, a random sample of the population was scanned with vascular ultrasound for early atherosclerosis. A continuous classical risk marker model (waist circumference, HbA1c, LDL/HDL ratio, pack years and pulse pressure) was compared to a model of modern biomarkers (C-reactive protein, troponin I, N-terminal pro B-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin, and asymmetric dimethylarginine) with regard to the ability of ruling out abnormal intima-media thickness (IMT), respectively, carotid plaques.
Data of the first consecutive 5,000 participants (aged 35-74 years; 2,540 men, 2,460 women) were analyzed. IMT was measured at both common carotid arteries using an edge detection system. Plaques were defined as protrusion of ≥1.5 mm in common, internal and external carotid artery.
For classical risk factors, in comparison to a model of six modern biomarkers, regarding the variable (a) IMT>0.85 mm negative and positive predictive value (NPV and PPV) were 0.98 and 0.16 for both the classical risk factor model and the biomarker model. The second variable (b) presence of plaque could be ruled out with an NPV of 0.84 and identified with a PPV of 0.61 for classical risk factors, and 0.84 and 0.58 for biomarkers, respectively. Values were calculated using logistic regression analysis.
Classical risk factors allow ruling out pathologic IMT and presence of carotid plaques in a population of primary prevention in a reliable way. Modern biomarkers performed almost equally well but did not provide further information.
在古腾堡健康研究中，对人群进行了血管超声扫描，以早期发现动脉粥样硬化。将经典的连续风险标志物模型（腰围、HbA1c、LDL/HDL 比值、吸烟包年数和脉压）与现代生物标志物模型（C 反应蛋白、肌钙蛋白 I、N 端 pro B 型利钠肽、 copeptin、中段促肾上腺皮质素、非对称性二甲基精氨酸）进行比较，分别评估它们排除异常内膜中层厚度（IMT）和颈动脉斑块的能力。
分析了前 5000 名连续参与者（年龄 35-74 岁；2540 名男性，2460 名女性）的数据。使用边缘检测系统测量颈总动脉的 IMT。斑块定义为颈总、颈内和颈外动脉的突起≥1.5mm。
对于经典危险因素，与 6 种现代生物标志物模型相比，在变量（a）IMT>0.85mm 时，经典风险因素模型和生物标志物模型的阴性和阳性预测值（NPV 和 PPV）分别为 0.98 和 0.16。第二个变量（b）排除斑块的 NPV 为 0.84，使用经典危险因素可识别，PPV 为 0.61，使用生物标志物可识别，PPV 为 0.58。使用逻辑回归分析计算值。
经典危险因素可可靠地排除原发性预防人群病理性 IMT 和颈动脉斑块的存在。现代生物标志物的表现几乎相同，但没有提供更多信息。
